Analyzed retrospectively data from patients of non-small cell lung cancer (NSCLC) with microscopic residual tumor at the bronchial resection margins (MRB) to discuss the prognosis and management. Data of 110 patients with MRB from 4017 patients of NSCLC (2.7%) who underwent operations in our hospital from January 2003 to December 2008 was analyzed. Histological types were: 74 squamous cell carcinoma, 32 adenocarcinoma, and 4 adenosquamous carcinoma. Nine tumors were pathological Stage Ib, 13, Stage IIa; 14, Stage IIb; 64, Stage IIIa; and 10, Stage IIIb. Surgery procedures were: 63 lobectomies, 19 sleeve lobectomies and 28 pneumonectomies. MRB included: 15 carcinoma in situ, 38, mucosal residual disease, 39,extramucosal residual disease and 18 lymphangiosis carcinomatosa. Sixty-nine patients received chemotherapy, 54 received postoperative radiotherapy. Survival rates were calculated by Kaplan-Meier and Log-rank. Multivariate analysis by Cox regression was taken (two-sided test, p < 0.05). Median follow-up was 21 months, 67 patients had died , the median survival time (MST) was 26 months , 1-y, 2-y, 3-y, 5-y overall survival rates (OS) were 81%, 51%, 39%, 31%, respectively. Univariate analysis implied that OS in cases with squamous cell carcinoma (p = 0.0065) and Stage I and II (p = 0.0087), pN0∼1 (p = 0.0086), margins other than LC (p = 0.041) and without vascular invasion (p = 0.044) were prior to the corresponding counterpart. Adjuvant chemotherapy (p = 0.079) and radiotherapy (p = 0.069) tended to improve OS. Adjuvant radiotherapy improved OS for cases in Stage III (p = 0.018). Multivariate analysis suggested that histological type (HR 2.27, 1.32∼3.89, p = 0.003), pathologic stage (HR 2.20, 1.20∼4.00, p = 0.010), vascular invasion of the hilus or mediastinum (HR 2.53, 1.34∼4.80, p = 0.004),adjuvant chemotherapy (HR 0.44, 0.26∼0.74, p = 0.002) and radiotherapy (HR 0.60, 0.36∼0.98, p = 0.044) were independent prognostic factors for OS. Histology type, pathologic stage, vascular invasion, adjuvant chemotherapy and radiotherapy were independent prognostic factors for patients of NSCLC with MRB; Adjuvant radiotherapy improved OS for cases in Stage III.